Provider Demographics
NPI:1881893360
Name:REYNOLDS, MEGAN RIZZI (MS, RD, CSR, LD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:RIZZI
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MS, RD, CSR, LD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ANNE
Other - Last Name:RIZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:1991 CROCKER RD STE 600
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-6970
Mailing Address - Country:US
Mailing Address - Phone:330-766-1818
Mailing Address - Fax:833-536-1767
Practice Address - Street 1:1991 CROCKER RD STE 600
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6970
Practice Address - Country:US
Practice Address - Phone:330-766-1818
Practice Address - Fax:833-536-1767
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5859133V00000X, 133VN1005X
976357133V00000X
FLND10800133VN1005X
A-3771264171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No171400000XOther Service ProvidersHealth & Wellness Coach